Under The Knife

On the Road Again

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So it's the week before the trading deadline and I spent most of my day on planes, or rather, in airports waiting on planes. There are finally things percolating, but for now, let's stick to injuries as I make the first of a couple letters from the road.

Powered by Kate Ferris, who makes sure that cancelled flights don't strand me, on to the injuries...

What is Carlos Beltran doing and why aren't the Mets stopping him? Beltran is playing with patellar tendonitis, an injury that is often fixed by rest and can be aggravated by almost any movement, especially lateral or traumatic movement. This is exactly the type of thing he did last season with poor results. The Mets are running away with the division, no pun intended, and yet they aren't finding ways to buy rest for anyone short of Pedro Martinez (who will start Friday). The bonus of having a big lead is setting your own schedule and agenda. The Mets have to start thinking about not only keeping Beltran ready for the playoffs, but for the term of his big-dollar contract. The Braves are the chasers, but by resting Andruw Jones and Chipper Jones, saving them for the Mets series this weekend, they're showing a confidence and knowledge of how this long season works that is both the benefit of experience and the type of decision that has given them this experience.

Derrek Lee surprised no one by heading to the DL yesterday. Designated an "aggravation" of his wrist injury, it's a perfect description of this injury and this season for Lee and the Cubs. As I'd discussed, Lee's wrist is showing the signs of soft tissue problems, as well as the complex sounding "post-traumatic inflammation of the outer bone of the medial side of his wrist." Umm, okay. Anatomic position for the wrist is palm up, so the thumb side is lateral, not medial, adding some confusion to the already confusing area. (Quick lesson: medial is closer to the midline of the body, lateral is further away. Your big toe is medial and the wee-wee-wee piggy is lateral.) Lee's return is going to depend on his response to treatment, and he hasn't responded well over the past two weeks. The worst-case scenario is that he misses the rest of the season and requires surgical intervention. It doesn't look like it will go that far, but there's no timetable either. Mark O'Neal continues to insist that this episode isn't a step back, though I have no idea how he can justify that.

>One thing that's bothering me more and more is failure by design. I wish I had a better term for it or a better example, but let's look at the use of Javier Vazquez. Vazquez is a starting pitcher, by definition supposed to go at least six innings and 100 pitches. (Yes, that's Bob Feller you hear grumbling.) Vazquez has, over his last several starts, died out at 75 pitches. Last night, Vazquez was having a nice outing through five, then hit the sixth at 69 pitches. True to form, he gave up a single and a pair of home runs in the sixth at precisely the point where he's shown trouble. You can read the box score for the rest. The White Sox have a decent bullpen, certainly one where they could pair Vazquez with someone like Brandon McCarthy and get through one game well. Ozzie Guillen is not someone who's been boxed in by anything as a manager, so I don't mean to make him the poster boy for this. It's epidemic. (Thanks to Keith Scherer for pointing this out.)

The Red Sox are looking to the past, doing what I call "squeezing the orange" with David Wells and Keith Foulke. The team isn't deluding itself that their two returning pitchers can change the team, acting like acquisitions, but maybe they have some juice left in them, enough to make it worth that last squeeze. Wells could hold up, or not, and the team will be fine either way, so it's worth a try. He looked good in a sim game, forcing the team to consider his next step. It could be a start. Foulke also is showing some life in his side sessions. He's further off, but could help take some of the load off the pen in September, if nothing else.

Jose Guillen has more than just a swollen elbow. The Nationals outfielder has a near-complete tear of his elbow, putting him on Jim Andrews' operating table once the swelling goes down. It's a bad break, but the return rate for position players is very good. OFs can look to Luis Gonzalez as a great example of how quickly a position player can come back from the surgery that knocks a pitcher out for most of a year. Guillen could be back for Opening Day of next year.

A weekend of rest didn't help Rafael Soriano, who continues to struggle with shoulder soreness and fatigue. Soriano's longstanding arm problems are a remnant of the Mariners' armshredding ways, something they may have put behind them based on their numbers this season. Soriano has good stuff still, but he's showing seasonal fatigue far too early in the season. One thing I'm working on is some sort of multiplier or factor for a pitcher who's missed time with injury. His innings and PAP won't be high, but there's some additional stress placed on the arm pitching with injury, working hard in the rehab phase, and working on the side and in the minors that aren't reflected in the IP total. That's another one on the long list of things to do. Of course, when we push out BP2020, I'll probably still have a long list and plenty more to learn.

Johnny Damon had back spasms while driving, a recurrence of the problem that he dealt with earlier in the season. Damon's health record was a touted part of his signing package, but it might be more accurate to say that he's among the fastest healers around. Don't expect this to stick around as long as, say, Robinson Cano and his hamstring problem. Cano has missed nearly a month, but is closer. He's down in Tampa and has done everything but run the bases at full go. Cano should start a rehab stint later this week.

The word was good from Dr. Jim Andrews after his latest look at Octavio Dotel. You'll remember that Dotel did some doctor shopping before his Tommy John and he's seen several during his rehab. There's pain in his rebuilt elbow, but no structural or nerve problems. There's no way to set a reasonable timetable on Dotel's return. He's teased the Yanks for a while.

Quick Cuts: I've heard more crazy ideas about Eric Chavez in the past couple days than I know what to do with. The A's don't seem to have any notion, so maybe one of these crazy ideas is right. If you've got it, you'll get credit here … Dallas McPherson injured his back again while on rehab assignment in Triple-A. He's headed back for tests, leaving his trade value behind … John Kruk said that Andre Ethier is going to be better as he learns the league. I wish I could tell you who it was he mentioned last week, saying it's tougher the second and third times around the league. So, which is it, Krukker? … There was a load of minor leaguers busted under the drug policy yesterday. No big names, but this isn't about big names. It's about enforcing the rules. On that front, this could be huge.